Guatemala Report Finds Indigenous Population Not at Higher Risk for HIV

Despite higher risk for a host of other health problems due to social vulnerability, indigenous Mayans in Guatemala are not at a higher risk for HIV compared with other Guatemalans, according to a recent MEASURE Evaluation study.

Despite higher risk for a host of other health problems due to social vulnerability, indigenous Mayans in Guatemala are not at a higher risk for HIV compared with other Guatemalans, according to a recent MEASURE Evaluation study.

The Maya and other indigenous groups account for approximately half of Guatemala’s population, and previous research has shown these groups to be markedly disadvantaged with respect to health and welfare. However, the MEASURE Evaluation study marks an effort to assess the group’s HIV risk based on behavioral and demographic factors, using data from a 2008-2009 national maternal and child health survey.

The study examined HIV risk by ethnic group and analyzed data from 16,205 women aged 15 to 49 years old and 6,822 men aged 15 to 59 years old who participated in the national survey. Ethnicity was measured by respondents’ self-reporting and by interviewer observation. Nearly 13% of female respondents and 8% of male respondents who self-identified as indigenous were classified as non-indigenous by the interviewer. Far fewer respondents (less than 2% of males and females) self-identified as non-indigenous but were classified as indigenous by the interviewer. Three categories of ethnicity were used in this study: indigenous, cross-identified (respondents who self-identified as indigenous but were classified as non-indigenous by the interviewer), and non-indigenous.

Study investigators also controlled for sociodemographic factors, such as age, education, marital status, and wealth; and they analyzed associations between ethnic group and respondents’ odds of early sexual debut, greater number of sexual partners during their lifetime, condom use, HIV testing, comprehensive knowledge of HIV, sex worker patronage, and accepting attitudes toward people living with HIV (PLHIV). Both male and female indigenous respondents had significantly lower levels of HIV knowledge and testing than the non-indigenous or the cross-identified groups. But indigenous respondents were less likely to report risky sexual practices overall.

Judith Timyan, acting director of the U.S. Agency for International Development’s health and education office in Guatemala, says that an interesting part of the study is how it looks at ethnicity itself. “We are also very pleased to have the links between ethnicity and HIV risk behavior addressed.”

Despite the study’s finding that indigenous groups are not at an increased risk for HIV based on the behavioral factors included in the survey, the study did find that the indigenous group lacked HIV awareness, had limited understanding of how HIV is transmitted, and held more negative attitudes toward PLHIV.

Recommendations resulting from the study include that prevention efforts should continue to focus on key priority groups at higher risk for HIV, such as men who have sex with men and sex workers. However, the finding that indigenous populations exhibit limited HIV knowledge and low rates of HIV testing, even relative to other groups in Guatemala, shows there is a need to provide more basic HIV education and overcome testing barriers in these groups. The report also emphasizes the complexities of measuring ethnicity and the importance of including new measures of indigenous status when conducting health research in Guatemala. Researchers working with health data from Guatemala are encouraged to analyze their outcomes by ethnicity so that programs and policies can be designed while taking into account the particular needs of indigenous communities.

MEASURE Evaluation is funded by USAID to strengthen capacity in developing countries to gather, interpret,
and use data to improve health. We create tools and approaches for rigorous evaluations, providing evidence to address
health challenges. And we strengthen health information systems so countries can make better decisions and sustain good health
outcomes over time.

MEASURE Evaluation is funded by the United States Agency for International Development (USAID) and the
U.S. President's Emergency Plan for AIDS Relief (PEPFAR). The information provided on this web
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